Aud Test 2

Front 1

Speech Recognition Threshold

Back 1

a speech thest that determines the lowest level a patient can correctly identify words at least 50% of the time.

Front 2

Speech Awareness Threshold

Back 2

the lowest level where the patient can detect speech 50% of the time.

Front 3

Word Recognition Score Test

Back 3

Assesses a client's ability to identify one syllable words that are presented at supra threshold levels, or the most comfortable loudness level.

Front 4

PB Max

Back 4

a person's maximum speech recognition score, usually in reference to percent correct of phonemically balanced words used in word recognition score tests. This is a theoretical number, unless you tests at many different levels.

Front 5

MLV

Back 5

Monitored live voice; the clinician uses their own voice.

Front 6

W2

Back 6

This is the SRT test.

Front 7

W22

Back 7

This is the Word ID test.

Front 8

PB

Back 8

Phonetically balanced; the lists contain all phonetic elements of typical English discourse in their normal proportion to one another.

Front 9

Half-Lists

Back 9

25 words; can be used if the client misses no more than two words out of 25, or if the client gets no more than two words correct out of 25 words.

Front 10

Word Recognition Scores

Back 10

are calculated as a percentage, with each word counting as 2% when 50 words are presented.

Front 11

One syllable right...

Back 11

on the SRT this is correct. On Word ID this is wrong. "knee" said as "knees" would be wrong.

Front 12

WRT Instructions

Back 12

"I am going to say a sentence, and I want you to repeat the last word of the sentence back to me. Some words are going to be harder to hear than others, so I encourage you to guess if you're not sure."

Front 13

WRS Interpretation

Back 13

No "real "scoring, we use mostly descriptors.

90 to 100% is considered normal (excellent).

We expect people with conductive losses to be in the "normal" range.

Front 14

cochlear disorders

Back 14

people with these have word recognition scores consistent with their amount of hearing loss. The greater the amount of loss, the poorer the WRS.

Front 15

Retrocochlear

Back 15

People with lesions beyond the cochlea, and into the 8th nerve generally have scores that are much poorer than their degree of hearing loss. There is a neural distortion that lowers their scores.

Front 16

Sensorineural Losses

Back 16

are at or better than what you might expect.

Front 17

People with Normal Hearing

Back 17

are very resistant to loudness levels. At 55 dB SL they go to 100%. Nothing happens at 60, 70, 80, 90. It stays the same.

Front 18

Loud and Soft Sounds

Back 18

differ in a range of about 30 dB

Front 19

The lower the pitch

Back 19

the more harmonics

Front 20

70% of your Word Scores

Back 20

Comes from around 500 - 2000 Hz.

Front 21

At 2000 Hz (plus or minus an octave)

Back 21

this is the key frequency for the intelligibility of speech.

Front 22

Predictability

Back 22

The sensory and neural part of the score should be able to predict how the patient will do based on the percentage of the score. Lower octave is worth 25%. 2000 is worth 35%.

Front 23

Damage to Cochlea; Hair Cell Damage

Back 23

Word ID scores will be at or better than what we are going to predict.

Front 24

Peripheral Auditory System

Back 24

is outside of the 8th nerve (which becomes part of the central system). Peripherally is happening to the sensory organs.

Front 25

Functional/Non-Organic

Back 25

a hearing loss with no organic basis. Psychological vs. Physiological. Sometimes a person imagines a hearing loss that can't be physically found.

Front 26

Organic

Back 26

Virtually everyone we see is going to have an organic disorder with a physiological basis. The vast majority are going to be peripheral.

Front 27

Conductive Losses Characteristics

Back 27

are a result of a problem from the outer ear to the oval window. This does not change acuity. the inner ear should be normal. If you make a signal loud enough, these will do well on Word ID.

Front 28

Diagnoses

Back 28

Audiologists cannot diagnose lesions (MD). We can diagnose the site of a lesion, to determine where there may be a problem. We can also diagnose the presence or absence of a hearing loss.

Front 29

What is the cause of Atresia

Back 29

Malformation of the outer ear canal; failure to form during embryologic development.

Front 30

Location of Atresia

Back 30

Outer Ear Canal

Front 31

Complaints of Atresia

Back 31

None in infancy, may have classroom difficulty as a child.

Front 32

Physical Signs of Atresia

Back 32

Atretic condition on the affected side; usually unilateral, and may have microtia (malformed pinna), abnormally small auricle.

Front 33

Treatment of Atresia

Back 33

Elective surgery, cutting an ear flap, BAHA hearing aid, preferential seating in the classroom.

Front 34

BAHA

Back 34

Bone anchored hearing aid. A steel bolt is put in the ahead, and a bone oscillator is attached to it. This is attached to a microphone, which recieves a bone conduction signal.

Front 35

Impacted Cerumen

Back 35

Fancy term for excess ear wax. Cerumen plug that makes it unable to visualize the TM.

Front 36

Impacted Cerumen Location

Back 36

Outer ear

Front 37

Impacted Cerumen Cause

Back 37

Cleaning ears with cotton swabs.

Front 38

Impacted Cerumen Complaints

Back 38

Difficulty hearing on affected side.

Front 39

Impacted Cerumen Audiogram

Back 39

Mild conductive loss on affected side.

Front 40

Impacted Cerumen Treatment

Back 40

removal of cerumen by health provider, softening agents, advising patient not to use cotton swabs to clean ears.

Front 41

Sebaceous Glands/Hair

Back 41

in the first third to half of the outer ear

Front 42

Swimmers Ear

Back 42

Otitis externa; this is not an audiological issue, but a dermatological issue. This only becomes an audiological issue if swelling reaches the point of causing a conductive loss.

Front 43

Otitis Externa Causes

Back 43

this is a skin issue. the pH balance in the ears is very sensitive, and chlorine can throw this off. drying agents are used to treat the problem.

Front 44

effusion

Back 44

an accumulation of fluid in the middle ear.

Front 45

serous otitis media

Back 45

fluid in the ear that is clear and noninfected.

Front 46

Serous Fluid

Back 46

clear, thin, sterile. fluid is drawn from the lining of the middle ear, and looks like bubbles.

Front 47

Purulent

Back 47

pus-like, infected. this takes on some color, and is milky-white. may have a cloud-like effect.

Front 48

Mucoid

Back 48

thick, mucus like. quite thick, and advanced/severe. This can lead to "glue ear". Very smelly.

Front 49

Number One Conductive Disorder

Back 49

Otitis media

Front 50

Acute

Back 50

0 - 21 days (three weeks)

Front 51

Sub-Acute

Back 51

22 Days to Eight Weeks

Front 52

Chronic

Back 52

Eight Weeks or Longer

Front 53

Eustachian Tube Dysfunction

Back 53

this is when the ET is unable to equalize the air pressure in the middle ear, creating a negative pressure in the middle ear as the remaining air becomes absorbed by the tissues of the middle ear.

Front 54

Causes of ET Dysfunction

Back 54

Adult and child developmental differences, or allergy, upper respiratory infection, or enlarged adenoids. This can also result from a sudden extreme change in pressure.

Front 55

How does the middle ear fluid become infected?

Back 55

due to coughing and sneezing.

Front 56

How does acute otitis media present?

Back 56

otalgia; ear pain. this may be a result of the inflammation of the TM. When you force the eardrum in our out, this is painful.

Front 57

Otitis Media Cause

Back 57

Eustachian tube dysfunction and fluid buildup in the middle ear.

Front 58

Otitis Media Location

Back 58

Middle Ear

Front 59

Otitis Media Complaints

Back 59

difficulty hearing, lack of attention in school, pulling on ears, fever, irritability.

Front 60

Otitis Media Audio

Back 60

mild to moderate conductive loss which depends on the amount and consistency of fluid in the ear. may be unilateral/bilateral.

*This is a loss that may RISE at higher frequencies.

Front 61

Otitis Media Treatment

Back 61

medical observation may need antibiotics for infection. PE tubes for chronic or reoccuring cases.

Front 62

Can he see and can he hear?

Back 62

Every meeting with a parent should start with this question.

Front 63

Aerotitis Media (barotrauma)

Back 63

the inability to get the air to pressurize in the middle ear space. this is usually the result of an extreme change in pressure (scuba diving, etc.)

Front 64

Tympanosclerosis

Back 64

50% of people who get PE tubes experience thickening/scarring which creates a mild conductive loss.

Front 65

Vasalva Maneuvers

Back 65

When you hold your nose and blow. This creates pressure in the mouth, you have to do this gently.

Front 66

Ossicular Erosion

Back 66

when the bones start to dissolve because of fluid.

Front 67

Ossicular Disarticulation

Back 67

this occurs when the ossicles start to come apart; because of major trauma.

Front 68

Disarticulation Location

Back 68

Middle Ear

Front 69

Disarticulation Cause

Back 69

slap to ear, head trauma, cholesteatoma

Front 70

Disarticulation Physical Signs

Back 70

none; hyperflaccid TM upon otoscopy

Front 71

Disarticulation Complaints

Back 71

hearing loss in affected side

Front 72

Disarticulation Audio

Back 72

moderate to moderately severe conductive loss on affected side.

Front 73

Disarticulation Treatment

Back 73

ossicular reconstruction, if needed. CROS hearing aid. BAHA if surgery is not done, or if hearing is not restored after surgery.

Front 74

Cochlear Otosclerosis Causes

Back 74

bony growth of temporal bone invades cochlea. Toxins destroy hair cells in the cochlea.

*This can wipe out the hair cells.

Front 75

Cochlear Otosclerosis Location

Back 75

Middle Ear around oval window and cochlea.

Front 76

Cochlear Otosclerosis Complaints

Back 76

progressive difficulty hearing and understanding speech.

Front 77

Cochlear Otosclerosis Physical Signs

Back 77

None

Front 78

Cochlear Otosclerosis Audio

Back 78

Progressive mild to moderate sensorineural bilateral loss. May start as unilateral and progress to bilateral. Usually worse in mid-frequencies. No Carharts notch. If there is stapes fixation there may be a mixed loss and Carharts notch.

Front 79

Cochlear Otosclerosis Treatment

Back 79

Sodium flouride; hearing aids when HL affects communication.

Front 80

Noise Induced Hearing Loss

Back 80

loss that results from continuous and excessive noise exposure. this reults in a high frequency sensorineural loss.

Front 81

NIHL - Location

Back 81

Inner Ear

Front 82

NIHL - Causes

Back 82

disruption of sterocilia; outer hair cells followed by the inner hair cells. can produce biochemical changes in hair cells or structural damage to the cochlea.

Scar tissue may form where hair cells used to be.

Front 83

NIHL - Complaints

Back 83

difficulty hearing; especially in sound. high pitched tinnitus.

Front 84

NIHL - Audio

Back 84

bilateral sensorineural loss, that begins as a notched loss. 3-6 kHz region. Progressive, and eventually affects a wider frequency range.

Front 85

NIHL - treatment

Back 85

none for existing damage. hearing protection to prevent further damage, and a hearing conservation program for a noisy environment.

Front 86

dBA

Back 86

a set of rules for how long you can work in noise, and how loud the noise is (8 hours).

in reference to NIHL, a measurement of weighting for sound level meter. A, B, C, D. Filter incoming sound. With noise level measures we use A weighted. A weighting provides a mimic of a normal person hearing sounds at 40 dB.

Front 87

85 dBA

Back 87

the gov't. says that employees should be offered protection, as this level is potentially dangerous. Wearing protection is at the employee's discretion.

Front 88

90 dBA

Back 88

this is the action level. an employee must wear protection. or he/she can be fired.

Front 89

5 dB change (dBA)

Back 89

For dBA, half the time or a 5 dB change. 95 dBA = four hours. 100 dBA = two hours.

Front 90

Environmental Controls

Back 90

could make things easier for employers, and this would prevent them from having to worry.

Front 91

Nosiocusis/Sociocusis

Back 91

Some suggest that hearing in old age is a result from living in a noisy environment our whole lives.

Front 92

Rows of Hair Cells

Back 92

Outer = 3

Inner = 1

Front 93

Presbycusis and Statistics

Back 93

hearing loss associated with aging.

Statistics: 1 in 11 (21 million) are hearing impaired.

Over 65: 25 - 40 %

90% by the age of 90

Most common disorder of sensorineural loss.

Front 94

Result of Hearing Impairment in Elderly

Back 94

Psychological: depression, confusion, inattentiveness, tension, and negativism.

Physiological: poor health, reduced mobility, reduced interpersonal communication has been associated.

Less than 20% of the hearing impaired elderly receive rehabilitation

Front 95

Hearing in Noise

Back 95

this might be the first symptom indicating that things are starting to change.

Front 96

Presbycusis Gender Differences

Back 96

Women have a tendency to lose low frequency hearing; but retain the high.

Men lose high frequency hearing.

Front 97

Presbycusis Location

Back 97

Inner Ear

Front 98

Presbycusis Causes

Back 98

hearing loss due to aging, starts at around age 50. Affects cochlear hair cells, stria vascularis, and/or neural pathways.

Front 99

Presbycusis Complaints

Back 99

Difficulty hearing, especially in noise. High pitched tinnitus.

Front 100

Presbycusis Physical Signs

Back 100

None

Front 101

Presbycusis Audio

Back 101

Bilateral sensorineural loss. Range of degree and frequency slowly increase with age.

Front 102

Presbycusis Treatment

Back 102

none for existing loss; hearing aids will help those whose loss is affecting communication.

Front 103

Presbycusis: Four types of loss

Back 103

sensory, neural, strial or metabolic, mechanical or cochlear conductive

Front 104

Sensory Loss (presbycusis)

Back 104

degeneration of the hair cells.

Front 105

Neural Loss (presbycusis)

Back 105

loss of cochlear neurons, resulting in problems of transmission information coding.

Front 106

Strial or Metabolic (presbycusis)

Back 106

degeneration (atrophy) of stria vascularis.

Front 107

Mechanical or Cochlear Conductive Loss (Presbycusis)

Back 107

results from alterations to cochlear mechanics.

Front 108

Stria Vascularis

Back 108

"food wagon" for inner ear; supplies nutrition to cochlea.

Front 109

Endolymphatic Hydrops

Back 109

a decreased ability to regulate the fluid (endolymph) balance of the inner ear.

Front 110

Meniere's Location

Back 110

Inner Ear

Front 111

Meniere's Cause

Back 111

endolymphatic imbalance in the scala media or vestibular labyrinths. may occur spontaneously, viral attack, or late onset genetics.

Front 112

Meniere's Complaints

Back 112

ocean roar tinnitus, aural fullness, hearing loss in affected ear. vertigo that may be debilitating.

Front 113

Meniere's Audio

Back 113

Fluctuating, low-frequency, sensorineural loss initially. May end up with a permanent, flat, moderate sensorineural loss. Often see best thresholds at 2000 Hz.

Front 114

Meniere's Treatment

Back 114

eliminate salt and caffiene from the diet. may be prescribed diuretic. Severe cases may require endolymphatic shunt operation or vestibular/cochlear nerve section.

Front 115

Ototoxicity

Back 115

hearing loss due to chemicals or harmful substances, pharmaceuticals/drugs.

Front 116

Drugs that Cause Ototoxicity

Back 116

Antibiotics (end in -mycin)
Diuretics
Aspirin (change thresholds/tinnitus but reversible)
NSAIDS (meloxicam)
Anti-Malarials (quinine)
Chemotherapy Drugs (cisplatin)

Front 117

Ototoxicity Location

Back 117

Inner Ear

Front 118

Ototoxicity Cause

Back 118

biochemical damage to coclhear and/or vestibular hair cells from aminoglycoside antibiotic treatment.

Front 119

Ototoxicity Complaints

Back 119

slight hearing loss, high frequency tinnitus, often very sick from another disorder which is why medication was administered.

Front 120

Ototoxicity Audio

Back 120

Permanent bilateral, high frequency, sensorineural loss. Begins in high-frequency range. Degree of loss and range of frequency loss may increase over time.

Front 121

Ototoxicity Treatments

Back 121

none for existing loss, may alter drug therapy. hearing aids may help those with communication problems.

Front 122

Tinnitus

Back 122

involved with many disorders.
current research suggests that brain is making up for lack of noise. treated with diet changes, tinnitus maskers, or low gain hearing aids.

Front 123

Acoustic Neuroma

Back 123

a slow growing benign tumor on the 8th nerve. This will not spread, but may cause nerve damage that affects hearing.

Usually arises from the vestibular portion of the 8th nerve; which is where we may see symptoms first.

Front 124

Acoustic Neuroma - Location

Back 124

On 8th Nerve, may show in two places.

Internal Auditory Meatus, which is the ear canal for the 8th nerve.

CPA (Cerebellopontine Angle) which is where the cerebellum and the pons meet.

Front 125

Otosclerosis (bilateral)

Back 125

A bony spongiotic growth in the middle ear cavity, typically on the ossicles.

*can cause stapes fixation

Front 126

Otosclerosis Causes

Back 126

slow bony growth of temporal bone around stapes footplate. Appears in second to third decade, may have genetic link, exacerbated by pregnancy.

Front 127

Otosclerosis Complaints

Back 127

difficulty hearing; but may hear better in noisy situations.

Front 128

Otosclerosis Physical Signs

Back 128

may see a pinkish glow otoscopically; schwartz's sign

Front 129

Otosclerosis Audio

Back 129

progressive mild to moderate conductive loss as stapes fixation increases. may start out as unilateral and turn into bilateral. There is a characteristic BC notch at 2000 Hz (Carhart's).

Front 130

Otosclerosis Treatment

Back 130

elective surgery to replace stapes with prosthesis (stapedectomy). Hearing aids/BAHA also options.